Impact of COVID on Sports Injury Patterns, Changes in Mental Well-Being, and Strategies to Prepare for Future Pandemics in Sport

Abstract

COVID-induced risk of musculoskeletal injury and poor mental health in athletes may be mitigated by early injury prevention programs, resiliency, and support networks.

A Study on the Injury Rate of Spanish Competitive Athletes as a Consequence of the COVID-19 Pandemic Lockdown

“…Moreover, assuming that the athletes' workloads were approximately 20 to 40% of their normal workloads, the recommended time to return to top-level training without a high risk of injury would be estimated at 3-5 weeks [38], although the return was further complicated by the extreme need to return to normalcy in an extremely short time. This was the case for many elite athletes, who experienced a reduction in rest time between competitions [2,10,11,13], as well as changes in nutrition, sleep, and exercise habits [7]. This situation resulted in an increase in IR, especially musculoskeletal injuries, upon return to sports at all competitive levels, mostly in the first two weeks after the return [2,3,10,11,13,16,[39][40][41][42][43] To what extent has the IR changed after the lockdown (AL) when compared to before the lockdown (BL) in competing athletes?…”

“…This was the case for many elite athletes, who experienced a reduction in rest time between competitions [2,10,11,13], as well as changes in nutrition, sleep, and exercise habits [7]. This situation resulted in an increase in IR, especially musculoskeletal injuries, upon return to sports at all competitive levels, mostly in the first two weeks after the return [2,3,10,11,13,16,[39][40][41][42][43] To what extent has the IR changed after the lockdown (AL) when compared to before the lockdown (BL) in competing athletes?…”

“…These measures also compromised athlete training by limiting their physical activity, hindering their access to many forms of physical exercise and multidisciplinary sports teams (e.g., coaches, sports scientists, sports medicine professionals), and hampering team practices [4,9,10]. The reason for the closure was the concern about the elevated risk of COVID-19 infections in athletes due to the nature of competitive sports, i.e., close contact, tight locker rooms and training facilities, shared equipment, lack of social distancing, and the absence of face coverings during training and competitions [11]. A consequence of these restrictive measures was the interruption of sports competitions, disrupting sports and training routines [2,10,[12][13][14][15].…”

“…The COVID-19 crisis has created many challenges, including an optimal and safe return to sports competition. In terms of risk factors for injuries during the lockdown (DL), the inevitable change of routine, the scarce sports equipment available (in most cases), and home training programs [32] should be highlighted, since they entailed a marked reduction in training specificity, intensity, frequency, and duration [9,11,33]. The latter can be considered the most relevant, as the athletes, accustomed to face-to-face training supervised by multidisciplinary teams of physical exercise professionals (which varies depending on the competitive level), began to train on their own, based on instructions provided by e-mail, video, or audio; they were required to adapt to these training sessions according to the reality of the space and the material available in each one [34].…”

“…To reduce the detraining effects and to carry out an optimal and safe return to sports training and competitions, a progressive and well-structured exercise program following the lockdown is essential [13]. Athletes usually trained at home DL, focusing on bodyweight-based and weightlifting strength training, as well as cardiovascular endurance conditioning [9,11,35]. However, home-exercise programs (characterized by limited equipment and facilities) do not provide enough stimuli to replicate the conditions of real competitions and usually lead to irregular training loads and a reduction in strength and general fitness levels [2,7,9,11,12,19,36,37].…”